Healthcare Provider Details

I. General information

NPI: 1255369658
Provider Name (Legal Business Name): ROBERT A HILL P.A.-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 PINE GROVE AVE MCLAREN PORT HURON - EMERGENCY MEDICINE DEPARTMENT
PORT HURON MI
48060-3511
US

IV. Provider business mailing address

1221 PINE GROVE AVE MCLAREN PORT HURON - EMERGENCY MEDICINE DEPARTMENT
PORT HURON MI
48060-3511
US

V. Phone/Fax

Practice location:
  • Phone: 810-989-3300
  • Fax: 810-985-2671
Mailing address:
  • Phone: 810-989-3300
  • Fax: 810-985-2671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00636600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number020765
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10004259A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601004156
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.004755RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: